z Singapore National Eye Centre (SNEC) Moorfields Eye Hospital World Ophthalmology Congress

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Betel nut (Areca catechu). This plant is indigenous to the Malay Peninsula. The Malaysian state of Penang is named after the plant (Pinang in Malay). The betel nut contains a stimulant, arecoline, an alkaloid. The arecoline effect is highly complex and includes constriction of the pupil, decreased cardiac output, stimulation of various glands, and dilatation of blood vessels. The effect is described by some as similar to nicotine and to other was like "way too much coffee." Topical arecoline causes a considerable stinginess of the eye and induces a strong pupil constriction like pilocarpine. The constriction starts within 5 minutes reaching its maximum at 30 minutes and the pupil returns to normal in 90 minutes. The eye pressure drops in response to the pupil constriction but
unfortunately its effect is transient making it unsuitable for glaucoma treatment.


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